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PPPVN > Hygiene, handwashing and hospital design > Flashcards

Hygiene, handwashing and hospital design Flashcards

1
Q

Why is regular handwashing needed?

A

Remove bacteria and reduce level of residual bacteria

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2
Q

When do you need to wash your hands?

A

Before aseptic procedures

Before and after touching patients and their surroundings

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3
Q

How should you wash your hands properly?

A

Antimicrobial soap or alcohol based sanitiser

Use WHO handwashing protocol

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4
Q

What are the general requirements for hand hygeine?

A

Bare below elbows
Short clean and bare nails
Cover cuts in water proof dressing

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5
Q

Describe the stages of the WHO handwashing procedure

A 
Wet hands and apply soap
Palm to palm
Palm over back of hand with interlocked fingers (both sides)
Palm to palm with fingers interlocked
Hands clasped around each other with fingers interlocked
Rotational thumb rubbing
Clean fingers on palms
Rinse hands and dry
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6
Q

Why is infection control important?

A

Prevent HAI
Keep staff and patients safe
Maintain public health

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7
Q

How to clean kennels appropriately

A

Remove bedding and wash at 60 degrees
Remove organic material then remove any traces with detergent
Use disinfectant correctly
Wipe top to bottom

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8
Q

Define disinfectant

A

Killing or removal of microorganisms

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9
Q

Define antiseptic

A

Similar to disinfection but on living tissue

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10
Q

Define detergent

A

Solution with cleaning activity to remove organic matter

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11
Q

Define sterilisation

A

Removal of all microorganisms including spores

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12
Q

Define asepsis

A

Complete removal of all microorganisms including spores resulting in complete sterile state

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13
Q

How do bacteria exist in the environment?

A

Spores- dormant

Vegetative- living and replicating

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14
Q

What is the effect of viruses lipid envelope when trying to disinfect?

A

More easily removed as disinfectant removes lipid layer making it vulnerable

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15
Q

What are features of the ideal disinfectant?

A 
Broad spectrum
Non-irritant and non-toxic
Easy to use
Stable and not easily inactivated
Cost effective
Rapid action
Remains on surface for contact time
Not deactivated easily
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16
Q

What needs to be considered when choosing disinfectant?

A

Whats it being used on
Amount of organic matter involved
Contact time
Dilution

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17
Q

How do alcohol disinfectants work, what are they used for and what is an example?

A 
Cause cell membrane damage
Fast acting but no residual activity
Broad spectrum effect except against enveloped viruses and spores
Hand disinfection and patient prep
Surgical spirit
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18
Q

How do aldehyde disinfectants work, why aren’t they used and what is an example?

A

Denatures proteins, broad spectrum
Toxic and possible carcinogenic
Formaldyhyde

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19
Q

How do biguanide disinfectants work, what are they used for and what is an example?

A

Alters cell membrane permeability but inactivated by organic matter, good residual action.
Effective against bacteria, some fungi but not spores
Used for patient prep or surgical scrub
Chlorhexidine

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20
Q

How do halogen disinfectants work, what are they used for and what is an example?

A

Destroys proteins in cells
Broad spectrum
Cleaning surfaces and skin
Bleach

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21
Q

How do QAC disinfectants work, what are they used for and what is an exmaple?

A 
Inactivate enzymes and denature proteins
Some residual activity
Broad spectrum but not against unenveloped viruses or spores
Surface disinfection
Anigene
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22
Q

How to phenol disinfectants work, what are they used for and what is an example?

A

Denature proteins and disrupt cell membranes
Broad spectrum but not against unenveloped viruses or spores
Surface disinfection
Dettol

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23
Q

What is meant by a hospital acquired infection?

A

Infections acquired by patients during hospitalisation of acquired up to 30 days father discharge

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24
Q

What are common HAI?

A

UTIs
Pneumonia
Blood stream infections
Diarrhoea

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25
Q

What are some of the consequences of hospital acquired infections?

A

Client dissatisfaction
Longer hospitalisation
Higher morbidity
Multidrug resistance

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26
Q

What are common routes of infection of HAI?

A 
Urinary catheters
Surgery
IV catheters or blood taking
Implants
Feeding tubes
Contamination between patients
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27
Q

What are risk factors for HAIs?

A 
Elderly 
Young
Immunocompromised
Invasive devices
Endocrine disease
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28
Q

How are UTIs acquired in hospitals?

A

Urinary catheters main cause from repeated placement or poor hygiene

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29
Q

What are the signs of UTI?

A

Pyrexia

Colour or smell change in urine

30
Q

How to correctly insert urinary catheter to prevent UTI?

A

Wash hands and wear sterile gloves
Clean and clip area
Used closed system collection bag
Avoid repeated placement and remove as soon as possible

31
Q

What is the main cause of blood stream infections?

A

IV catheter use especially central lines when placed/maintained with poor hygeine

32
Q

How to prevent bloodstream infections from catheterising?

A

Wash hands
Clean and clip area
Use sterile equipment
Remove catheter as soon as possible and avoid repeated placement

33
Q

How to prevent infectious diarrhoea?

A

Wash hands and clean accommodation thoroughly between patients
Regularly deep clean facilities
Limit transport in and out of ward when there is an outbreak

34
Q

What equipment is the main cause of pneumonia in patients?

A

ET tubes, circuits so need cleaning properly or disposing if cant clean

35
Q

What is the most common type of pneumonia and how is it prevented?

A

Aspiration, mainly when under GA

Starve patients before anaesthesia, secure airway ASAP and keep head elevated until cuff is inflated

36
Q

How to prevent superficial or systemic surgical infections?

A

Adequately prepare skin and personnel, use good theatre practice
Keep wound covered for 24-48 hours and only change when dirty or damaged

37
Q

What are some ways to prevent HAI?

A

Initial telephone calls can flag infection
Use SOPs between patients
Correctly dispose bodily fluids and waste
Handwashing
Barrier nursing when appropriate
Infection control team monitors and makes changes

38
Q

Where should you house those with poor immune status?

A

In normal wards but reverse barrier nusre

39
Q

What is mean by reverse barrier nursing?

A

Nursing those with poor immune systems before those with strong immune systems

40
Q

Where should you house those with strong immune systems?

A

Normal ward

41
Q

Where should you house those with mild infectious disease?

A

In ward or isolation
When in ward use separate area, PPE and own equipment
Isolate when with immunocompromised patients

42
Q

Where should you house severely infectious patients?

A

Isolation with barrier nursing

43
Q

What are the features of isolation facilities?

A 
At least 5m away from other patients
Dedicated nurse
Disposable items where possible
Patient has own equipment
PPE on entrance
Use bedding wash bags to avoid handling
Use of SOPs
Minimise owner visits
44
Q

What is meant by HAIs being opportunistic?

A

Take advantage when patient is already compromised

45
Q

When should you suspect a resistant infection?

A

Not responding to antibiotics or is at risk

46
Q

How is resistant infections avoided?

A

Limit antibiotic use
Hand hygiene
Education of veterinary team
Report incidences to track any issues

47
Q

What is MRSA?

A

Methicillin resistant staphylococcus areus

48
Q

What issues to MRSA cause and how should you treat it?

A

Issues- unhealing wounds, sepsis

Treating- strict isolation

49
Q

What are the 5 freedoms that must be provided to patients?

A 
Freedom from pain, injury and disease
Freedom from hunger and thirst
Freedom from discomfort
Freedom from fear and distress
Freedom to express normal behaviour
50
Q

What considerations need to be in place for boarding environments?

A

Enough space to express normal behaviour
Able to disinfect
Enrichment and company when approptriate

51
Q

What considerations need to be in place for animals in hospital environments?

A

Space to express normal behaviour unless needs restricting or being disturbed due to injury or treatment
Be able to sterilise
Enrichment and company when appropriate

52
Q

What do you need to consider in hospital design regarding different species housing?

A

Different area for cats, dogs, exotics and isolation

53
Q

What are the key features of different structural materials?

A

Concrete- appropriate outdoors, time consuming to clean, cheap, reflects temperature of environment
Tiles- avoid, hard to clean, slippery and cold
Stainless steel- cheap, manufactured to fit, easy to clean, slippery, loud and reflective
Fibreglass- hardwearing, easy to clean, hard to ventilate but good for oxygen therapy

54
Q

What are the ventilation requirements in hospitals?

A

Clean air at least 4-8 changes per hour and more in isolation to reduce likelihood of airborne infections
Allows humidity and temperature control

55
Q

What are the different ways of ventilating?

A

Active- extractor fans, aircon

Passive- windows and doors

56
Q

What temperature should the hospital be at and why?

A

18-22 degrees

Helps mould and damp prevention and keeps everyone comfortable

57
Q

How can temperature be regulated in hospitals?

A 
Underfloor/central heating
Aircon heating systems
Radiators
Heat lamps, pads
Fans
58
Q

What are the different types of bedding that can be used?

A 
Fleece
Blankets
Towels
Covered foam wedges
Newspaper
Incontinence pads
Bean bags
59
Q

What are advantages and disadvantages of fleece bedding?

A

Adv- reusable, absorbent, warm

Dis- expensive, chewable

60
Q

What are advantages and disadvantages of blankets and towels for bedding?

A

Adv- reusable, washable, warm

Dis- expensive, non- draining

61
Q

What are advantages and disadvantages of covered foam wedges for bedding?

A

Adv- reusable, support for recumbency

Dis- chewable

62
Q

What are advantages and disadvantages of newspaper bedding?

A

Adv- some warmth, cheap

Dis- disposable, staples, ink leaking, no padding

63
Q

What are advantages and disadvantages of incontinence pads?

A

Adv- some warmth, absorbent

Dis- disposable, no padding, expensive

64
Q

What are advantages and disadvantages of bean bags for bedding?

A

Adv- reusable, insulating, comfortable, support

Dis- only cover is washable

65
Q

What needs considering for patients when putting them in kennels?

A

Temperament

Disease and injury

66
Q

How is the best way to approach and house animals when unsure on temperament?

A

Hands free when possible
Keep lead not slip attached
Keep on flood level
Never keep muzzle on

67
Q

How to move patients when in pain?

A

Slide where possible not lift

68
Q

What needs considering about mobility of patients?

A

Whether its acute or chronic

Ambulatory/walking or non-ambulatory

69
Q

How to manage recumbent patients?

A

Thick bedding
Incontinence sheets
Vet beds to wick away urine
Enough space to lift patients

70
Q

What do critical hospitalised patients needs?

A

Constant monitoring

Rapid access to life support

71
Q

How should infectious patients be hosptalised?

A

Barrier nursing
Isolation
Housed at bottom

PPPVN (14 decks)

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